My Dark Secret

OK, here it is: I have not read any Dr Sears book. Or indeed any book on attachment parenting. Yet I call myself an attachment parent. How can this be?

Well, first of all there is my aversion to "how to" books. In general I hate people telling me what to do. Since I was a child I have always preferred to figure things out myself. I have always leaned towards studying scientific subjects because I enjoy the fact that if you learn a few basic principles, you can usually work out the more complicated stuff for yourself. So I love reading anthropology, psychology and biology but I am wary of any books on parenting methodology.

Secondly, there was my fear when I was expecting Cave Baby that reading about parenting would somehow jinx the outcome of my pregnancy. The only book I brought home for us to read was the most basic, pared down guide to babies that I could find. With hindsight, I wish that I had read more, so I might have had a few more ideas of what to do when my baby would not stop crying and would not sleep. But it is questionable what can really be learned from a book. Having a first baby is a massive shock even to a well prepared family.

Thirdly, I am slightly uncomfortable about the label "attachment parent". It is a label I very rarely use. I use it on this blog because it is the quickest way of conveying to a reader what type of parent I am trying to be. In truth, I don't really know what "attachment parent" means. I know there are eight (or is it ten?) principles of attachment parenting, though I can't remember what they are. I know that lots of people who follow it also co-sleep, breastfeed and wear their babies in slings. And I know that it is based on more natural, intuitive ways of bringing up children than is the norm in our culture. I am wary of using the label "attachment parent" with people who are not familiar with what it means because I feel the word "attachment" has some negative connotations in some people's minds. "Attachment" implies clingy children wrapped around their mother's legs, whereas it really refers to a close, secure relationship between child and caregiver. I am also aware that lots of parents who have never heard of the concept are just as securely "attached" in their relationships with their children as any "attachment parent". I am wary of putting people into boxes.

Now despite not reading his books, I do have to admit that I breathed a huge sigh of relief when I discovered Dr Sears' website back in the darkest days of caring for the three month old Cave Baby. It was the first time I had read about babies who were as difficult to soothe as my baby, and the first time I had come across the label "high needs baby". With the help of the web, Dr Sears' influence extends far beyond those who have actually read the books.

So, if you are still reading, please tell me why I should go out and buy a book on attachment parenting. Seriously. I would probably enjoy reading it and my preconceptions about such books being too preachy and instructional are probably wrong. Are they interesting reads in themselves, regardless of the advice they give? All comments will be gratefully received.

Oh, and Earthenwitch seems to share some of my reservations about parenting books in this post, which you might also find interesting.

Cortisol: Friend or Foe?

The much studied and much misunderstood hormone cortisol is generally an unwelcome visitor to a baby's developing brain. But research has show that as the child grows up, the brain actually requires small amounts of cortisol to mature. This is the final post in a series of three that I have written about an infant's brain development after reading Sue Gerhardt's excellent book "Why Love Matters".

Babies and toddlers rely on adults to regulate their emotional state. That is one of the reasons why it is so important for a child to have a constantly present attachment figure, though this does not necessarily have to be a parent. The child's very survival depends upon the attachment figure and consequently the child is extremely sensitive to the positive and negative messages given by the adult.

A parent's positive face tiggers off a pleasurable reaction in a baby. The baby's heart rate increases, and beta-endorphin and dopamine are released. Beta-endorphin is an opioid and dopamine is a stimulant so both make the baby feel good. Both also help the young baby's brain to grow by increasing the brain's uptake of glucose. This is why positive interaction with a young baby is so vitally important.

But the flip side of the baby's pleasurable reaction to a happy face is its negative reaction to an angry or sad face. Seeing a negative expression on its parent's face is itself a stressful event for a baby, triggering the baby's stress response. The stress response is sometimes described as the HPA axis, which is shorthand for "hypothalamus triggers pituitary gland which triggers adrenal glands". Each of these glands produce hormones, the most famous of which is cortisol, produced by the adrenal glands. Although there are several hormones involved in the stress response, it is cortisol that is the most widely studied because it can be measured in saliva.

It is accepted that during babyhood, cortisol is detrimental to the development of a baby's brain. Since babies are unable to self-regulate their stress levels, they require their adult caregivers to repeatedly return them to a state of equilibrium by meeting their needs for food, comfort, safety and love. But in toddlerhood, something interesting happens to the role of cortisol in the child's brain. A toddler actually needs some cortisol to complete the development of their orbitofrontal cortex - the part of the brain that controls how the child responds to basic emotions such as fear and anger. Gerhardt explains:

"Increased levels of cortisol facilitate the growth of norepinephrine connections from the medulla up to the prefrontal cortex. This delivery of norepinephrine helps the orbitofrontal cortex to mature further in toddlerhood, by increasing blood flow to the area and by forming its links (via the hypothalamus) with the parasympathetic nervous system. The parasympathetic nervous system is vital to the growing child, because this is the inhibitory system which enables the child to stop doing something and to learn what behaviour is unacceptable or dangerous."

The requirement for some brief does of cortisol coincides very neatly with the period in a child's life when it is becoming mobile and inquisitive, and often putting itself in danger. When the parents scold the child or simply stop it from doing something, their negative facial expressions set off the child's stress response, giving his body a quick shot of cortisol. However, too much cortisol would still be bad for the developing brain and so it is important that the parents once again restore the child to its emotional equilibrium state quickly.

Parents of toddlers apparently say "No" an average of once every nine minutes - but at least they can do it in the knowledge that they are performing an essential role in their child's development!

"Why Love Matters" is divided into three sections on brain development, the consequences of a dysfunctional childhood, and the way forward. The three posts I have written have all been based on material from the first section on normal infant brain development. But the whole book is a fascinating read and I would wholeheartedly recommend it. And if you have any book recommendations of your own, please tell me in the comments - I would love to read more well thought out, well researched books on parenting.

If you enjoyed this post, you may like to read the earlier posts on the book: Why Are Human Infants Born So Prematurely and Why It Is Wrong To Leave A Young Baby To Cry.

You Are Right Mr Ballard

Inspiration about parenthood can come from the unlikeliest of sources.

From the first chapter of J.G. Ballard's autobiography, Miracles of Life:

"My closest family were an English faimly called the Kendall-Wards... There were three brothers, whom I remember well, but it was the parents who made a powerful and lasting impression on me... he and his wife were free spirits who rarely mixed on a social level with other British residents... The Kendall-Ward home was the complete opposite of 31 Amherst Avenue [Ballard's home], and an influence that lasted all my life... Relations between parents and children were far more formal in the 1930s and 1940s, and our house reflected this, an almost cathedral-like space of polished parquet floors and blackwood furniture. By contrast the Kendall-Ward home was an untidy nest, full of barking dogs, arguing amahs and the sound of Mr Kendall-Ward's power saws slicing through plywood, the three brothers and myself roller-skating through the rooms and generally runing wild. I knew that this was the right way to bring up children. Appearances counted for nothing, and everyone was encouraged to follow their own notions, however hare-brained. Mrs Kendall-Ward openly breastfed her baby, something only Chinese women did.... Her kindness and good nature I remember vividly some seventy years later. I was rarely unhappy at home, but I was always happy at the Kendall-Wards, and I think that I was aware of the difference at the time."

I want to be like the Kendall-Wards.

Pictures of Breastfeeding? Gosh, Take Them Away

A local NHS (National Health Servive) trust came under fire this week for featuring, among its breastfeeding awareness material, a picture of a child pretending to nurse. This picture was deemed unacceptable because it might cause offence to mothers who had been unsuccessful at breastfeeding. And Amanda of mmmm mama made a comment recently about how it is slightly taboo for happily breastfeeding mothers to sing the praises of breastfeeding lest they should step on the toes those who have chosen not to. How has the human race, whose females are equipped with mammary glands for the express purpose of feeding its young, possibly got itself into this ridiculous situation? Why would any mother be offended by a picture of a child breastfeeding, or another mother talking about it?

First of all, I must state some caveats. I am a breastfeeding mother. Though I have been extremely lucky to have had no major problems, I know lots of other women who have overcome serious challenges to establish breastfeeding. I know it can be very difficult. I also go to several baby groups and I am friends with mothers who bottle feed. They are good mums who love their babies and try to do the best for them. Although I support breastfeeding, I have nothing against mothers who formula feed. If we were to debate our feeding choices then we might disagree, but I do not seek confrontation like that. I know that breast milk is nutritionally superior to formula milk and provides better immunological protection to babies. For these reasons, I think we have a duty to encourage mums-to-be to breastfeed. I would like to understand how non-breastfeeding mothers feel when they see breastfeeding awareness posters, talk to breastfeeding mothers or read pro-breastfeeding writing. In the article below I have tried to imagine how I would feel if I was put in a variety of situations. Others may have very different feelings - I can only speak for myself.

I'm going to assume that breastfeeding mothers are not offended by the promotion of breastfeeding. That means it is the mums who either choose not to breastfeed, or ran into problems that meant they stopped, or simply could not breastfeed. I will first consider the mothers who are physically incapable of breastfeeding. There are several reasons why a woman might be genuinely unable to feed her child herself including illness, a pre-existing medical condition, previous breast surgery and having a very premature baby. I feel very sorry for any woman who would have liked to breastfeed but could not. It must be hard to come to terms with, and it must be painful to see and hear about breastfeeding when you so desperately wanted to do it yourself. But if I was in this position I cannot believe that I would be offended by discussion of breastfeeding. Of course I would not be so insensitive as to whitter on for hours about nursing with a friend who was unable to breastfeed, in the same way that I would not ramble for hours about pregnancy with a friend who was unable to have children. But we would be doing a huge disservice to the next generation of babies if we were to suppress the pro-breastfeeding message in order to spare the feelings of this very small minority of mothers (and I must not forget the fact that a mother who is unable to breastfeed might still be very pro-breastfeeding).

So I will move on to another group of mothers - those who have encountered problems that forced them to stop nursing before they wanted to, and those who think that their bodies are not capable of feeding their babies, but who are really the victims of a lack of support and information. How many first-time mothers have tried to breastfeed in hospital, found the support woefully lacking and concluded that they are unable to nurse? I imagine that in this position I would feel sadness, anger and bitterness. It is understandable that some people direct this anger towards the people who encouraged them to breastfeed. The tragic case of Katy Isden, who committed suicide four months after giving birth to a baby boy, is one example of how the blame for post-natal depression is sometimes heaped at the door of the pro-breastfeeding authoroties. Katy was known to be experiencing difficulties with breastfeeding but the sensationalist media wasted no time in putting two and two together to make five, reporting that her suicide came about because of the pressure she was under to breastfeed. There was absolutely no evidence to suggest that this was the case. Post-natal depression can strike any new mother, and breastfeeding is widely believed to have a role in preventing its occurrence. Difficulties in breastfeeding may well contribute to post-natal depression but that is no reason to stop encouraging new mothers to breastfeed. Rather, it shows that they need more support to help them succeed.

The lack of support received after birth can have far-reaching consequences in a breastfeeding relationship. There are mothers who manage to breastfeed for several weeks or months despite experiencing sore nipples which could have been prevented if they had been instructed in correct positioning and attachment. There are mothers who struggle to produce enough milk for their babies because they were encouraged to supplement their milk with formula during the crucial first fortnight, when the milk supply is being established. It might appear as if these mothers have nursed successfully, but it is no wonder that they may feel disillusioned and bitter towards the people who encouraged them to breastfeed if their own experiences have been painful and unhappy.

So I can understand why a mother who wanted to breastfeed, but was not adequately supported, might direct her ill-feeling towards the breastfeeding lobby. She may be saddened or angered by another mother talking positively about breastfeeding. But once again I do not feel that this is sufficient reason to suppress the pro-breastfeeding message. Many (possibly most) of the breastfeeding peer supporters at my local Children's Centre had very difficult experences with their first baby, but went on to breastfeed subsequent children successfully and became very vocal advocates of nursing.

The final group of women is those who choose to formula feed. Some people make this decision with full knowledge of the drawbacks of formula feeding compared to breastfeeding. Whilst I might not agree with their choice, I respect their right to make the decision that is most appropriate for their family. I cannot see how a fully informed woman in this situation can object to anybody else promoting breastfeeding. Research has proven the superiority of breastfeeding for babies' health, but presumably a mother who makes an informed decision to formula feed has judged that, on balance, her family will benefit more if she feeds from bottles. She would also have been aware, before making her decision, that she would continue to see posters about breastfeeding and socialise with breastfeeding women. If I had made such a decision, perhaps these constant reminders would make me feel guilty. But the decision would have been my own, and any negative feelings I had would be my own responsibility.

Unfortunately there are many people who make the decision to feed formula milk without being fully informed, or because they are virtually forced to by their close family. Some inherit prejudices against breastfeeding from the people around them. And there are those who do not give much thought to the decision, and feed formula because it is more familiar to them than breastfeeding. These people would certainly benefit from better antenatal education so that their decision could be made with the benefit of greater knowledge. To really make a difference to breastfeeding rates, the information must also be disseminated beyond the pregnant woman, to her partner and family. I do empathise with those who initially choose formula but later wish they had tried breastfeeding; it is a shame that this is an irreversible decision. Feelings of guilt for not breastfeeding must be hard to shake off, especially when the mother is exposed to pro-breastfeeding information. But I would repeat again that it is wrong to avoid promoting breastfeeding just to spare the feelings of mothers who feel guilty for their choices. It would be better to educate pregnant women more comprehensively so that the guilt scenario could be avoided in future mothers.

Normal human sensitivity must be employed whenever we talk about breastfeeding. Though there are hard facts that prove that breast is the ideal food for babies, it is completely wrong to judge or voice disapproval about mothers who formula feed. They may have very good and complex reasons for doing so. But any formula feeding mother who does take offence at the promotion of breastfeeding should also consider why she is offended, and if her offence really justifies the denial of breastfeeding information to mothers-to-be.

The solution to the whole unhappy situation would be to properly educate pregnant women about their feeding choices and provide robust, reliable support for new mothers who want to breastfeed. This is surely the only way to ensure that mothers are confident in the feeding decisions they make, and that women who want to breastfeed are successful. The mummy wars would not even exist if we were all truly happy with our choices.

A Manifesto for Living Like I Am On Holiday

Holidays are so flipping relaxing! Every time I return home I wonder how I can make my normal day to day life more like those fun times away. Our little family had a gorgeous weekend away recently, the first since we were blessed with our little Cave Baby, and this time I have vowed to do actually do something to make my life more like a holiday. Not too much - it has to be manageable within my normal routine. So here are my promises for how I will try to bring more calmness and happiness to our home:

1. Switch the TV off and fill the house with music instead. This is a two-in-one promise but they kind of go together, unless I just want crystal clear silence. Just now I am listening to Rufus Wainwright for the first time in nine months, and it is already making me feel happy. I spent all my time until the age of about 22 enveloped by music, but entering the world of work seemed to call a premature halt to all that and I fell into the all-too-easy habit of switching the television on. So, since music makes me feel good, I shall listen to it more.

2. Walk more slowly. Why do I rush everywhere? Even when I am walking down to the shops I overtake people and boil with frustration when I get stuck behind a couple of slowcoaches. This is no way to live! I think this promise may be more to do with changing my state of mind than changing my actual walking pace. Brisk walking is perfect to keep me fit, but there is no point in counteracting the health benefits by getting stressed when I have to slow down. Even if I happen to be rushing to make an appointment, a baby provides the perfect excuse for being late. Nobody expects a harassed mother to be on time for everything.

3. Read more. Reading is so much more satisfying than watching television. As a means of escapism, it is far superior. And despite requiring more mental exertion, it seems to leave the mind much more relaxed than an hour staring at a screen. On the face of it, my days would not appear to include many opportunities for reading. But when I have a really good book on the go I always manage to find time to read. There are times when Cave Baby is asleep, and times when she is going to sleep; times when she is playing with her daddy, and even times when she is in the mei-tai and I am waiting for a train. And to tackle the problem of my book never being near me when I want to read it, I will try to have a downstairs book and a different bedside book.

4. Smell the flowers. I mean literally, smell the flowers (and grass and mud and trees). It makes me feel so much better! It takes so little effort to pop outside for ten minutes and potter around the garden or walk around the block, but it calms me and Cave Baby absolutely loves it. So, whilst the weather is warm and clement enough to go outside in the evening, I will try to incorporate a little wander into our bedtime routine.

Right, that's it. Four small things that can hopefully make my life a little bit more joyful. And maybe by writing them down for all to see I can make myself hold to these promises.

The Real Benefits of Breastfeeding

Many people who stumble across this blog will also be readers of PhD in Parenting. But for anybody who isn't, there is a fantastic, authoritative article on the benefits of breastfeeding that is really worth a read. Like the author, I have often been confused by the many claims and counter claims about the relative benefits of breast and formula feeding. Unlike the author, I have not scoured the academic literature to pinpoint exactly what the real facts are. Read it: you will be amazed.

Top Ten Baby Things That You Do Not Need

The future parent is such a soft target for the multi million pound baby-stuff industry: so clueless, yet so eager to do the best for their baby. But I am sure of this: buying lots of stuff for your baby does not equate to being a good parent. And here are the top ten things that I wish I had not wasted the Earth's resources on:

1. Scratch mitts

Before Cave Baby's birth I had no idea why you needed these, but I bought some anyway because it seemed like the thing to do (see also: baby hats). After Cave Baby's birth I still had no idea what they were for but I kept them in the drawer in case it dawned upon me one day. Now they have been given away to charity I still have not managed to figure out the point of these things. Do some babies scratch themselves a lot? Don't they just work the gloves off their hands? Can't you just trim their nails so they are too short to cause any damage? I don't get it.

2. Night nursing bras

The books tell you that you MUST wear a bra AT ALL TIMES following birth or your breasts will drop to the floor and never return. Well, they may drop to the floor and never return but a night bra isn't going to make much difference. I wore a night bra with breastpads for a couple of weeks after giving birth and can say that: (i) the breast pads usually fell out and I inevitably forgot to replace them after a feed anyway; and (ii) half the time my breasts fell out as well, nicking the delicate nipples on the elastic at the edge of the cup as they did so. In conclusion, a night bra is less than useless. Put a towel under you to catch milk instead.

3. Baby lotion

What is baby lotion for? I always assumed it was to moisturise the baby. But then my dad told me that they used to use it to clean my bottom when I was a baby. And I noticed that there were a million other products on the market that you were supposed to use to moisturise your baby. Is this a genuine mystery or am I just clueless?

4. Infacol/Gripe water

In my humble opinion, these preparations are nothing but cleverly marketed pharmaceutical quackery. We were told by the midwives at our antenatal classes that Infacol would be essential for those first few difficult nights. I duly went out and bought some before Cave Baby even arrived. Sure enough, she was inconsolable in the evening of her second day so we tried dosing her with Infacol. Did it make any difference? No. After using it for a couple of days I suddenly had a moment of clarity and wondered what the heck was I doing shoving bizarre white orange flavoured gloop down my precious newborn's neck. And I put her next to me in bed. Final score: co-sleeping 1, Infacol 0.

5. Baby hats

In my pregnant ignorance I bought a baby hat because it seemed to be what you were supposed to do. And Cave Baby did wear this hat during her first couple of days when she slept all alone in a moses basket. Then I read that you weren't meant to put hats on babies' heads indoors, and I got all confused. Meanwhile, almost every relation of ours bought Cave Baby a little cotton hat. Now I am not a hat person myself but even if I loved hats I don't think I would need twelve different ones, all in slightly different pink flowery designs. As soon as she was given a beautiful knitted pink bonnet I forgot about the naff cotton baby hats and used the knitted hat for the next six months.

6. Other baby toiletries

Baby bubble bath, baby bath oil, baby shampoo, baby talc, baby oil, baby lotion, baby cream etc etc. Since when did tiny babies get dirty enough to requite this kind of industrial cleaning? This might be just me, but I find that my baby spends the majority of her time inside clean clothes, in a clean house, with very little opportunity for dirt transference on or off her squishy pink body. I see no requirement to strip her body of its natural moisturising oils and replace them with nice smelling fake ones. Until she starts crawling around the garden and getting properly dirty, I will stick to cleaning her with plain water and plain water alone.

7. Thousands of breast pads

I believed the Mothercare catalogue. It said that in your first week after birth you would require 100 breast pads. 100! A bit of elementary arithmetic breaks that down to 14.29 a day! Or, 7.14 per breast per day, assuming you have two breasts. That is a lot of changes of breast pads. I only used about three per breast per day even in the early days before my milk flow had equalised to Cave Baby's needs. Am I lucky not to leak too much, or am I just really dirty? Maybe if you are bottle feeding you need this many to absorb the unused milk, but if that is the case then Mothercare should really state that in their advice in the catalogue. Here is my advice - buy one packet of disposable breast pads to use in the early weeks, then move on to washable ones which are much prettier, and don't resemble a sanitary towel quite so much.

8. Bibs in newborn size

What I cannot grasp about bibs is why bottle fed babies need them but breast fed babies don't. I didn't buy any bibs before Cave Baby was born but we were given tons of them. Most could be kept for when she began eating solids, but some were newborn size with a very small neck hole. So, hating to leave anything unused, I thought maybe I could use one to stop the newborn Cave Baby covering her clothes in sick. But then I ran into two difficulties: (i) it was impossible to predict when she would be sick, so she would basically have to wear a bib all the time; and (ii) when she was sick, it just ran down the bib and soaked into her clothes anyway. This was not a very successful experiment and the bibs were soon consigned to the charity pile.

9. Cotton buds

You know, the little plastic sticks with a swirl of cotton wool on each end? I know they are useful for putting on make up and taking off nail varnish. But what is their application as far as a baby is concerned? What part of a baby's body is too small to admit a normal sized ball of cotton wool but robust enough to withstand an invasion by one of these mini pugel sticks?

10. Breast shells

What a great idea. Shaped plastic cups that sit on your breasts, with a little hole for your nipples, catching any milky leakage for you to feed to your baby on a later occasion. There is only one problem. How the heck do you fit your ample breastfeeding bosom and a pair of these inside your bra? And how comically large will your chest look if you do manage to fit everything in? The mind boggles.

So glad I've got this off my chest! Have I missed anything?